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Early Retiree Kaiser Permanente HMO
The Early Retiree Kaiser HMO provides comprehensive benefits for you and your covered dependents. Refer to the Plan Comparison or medical plan booklet for details. Here’s an overview:
Plan Features
Kaiser HMO
Provider choice
You must receive care from Kaiser Permanente HMO or affiliated providers except for emergencies.
How the plan pays benefits
Most covered services are paid in full after you pay any applicable copayment. For most office visits, copayments are $5 per visit.
Annual deductible
None
Annual out-of-pocket maximum
The plan has a limit on how much you have to pay out of your own pocket for covered services each calendar year:
$600/individual
$1,200/family
Once you reach the plan’s annual out-of-pocket maximum, the plan pays covered expenses at 100% for the rest of the calendar year.
Preventive care
Services include periodic health exams, annual women's exams, mammograms, well-baby care and routine immunizations.
Prescription drugs
Prescription drug benefits are provided through Kaiser HMO pharmacies or through the Kaiser mail order service.
Kaiser pharmacies (30-day supply): You pay 50% of cost of drug, up to $50 maximum copayment. Kaiser mail order (90-day supply): You pay 50% of cost of drug, up to $100 maximum copayment .
Vision
Kaiser Permanente members receive vision benefits through Kaiser: 100% after you pay a $5 copayment per exam; 100% up to $100 credit for lenses and frames and/or contacts, once every 24 months.
The Trustees have the discretionary authority to determine eligibility for benefits and to construe the terms of the Plan.The Plan may be amended periodically by the Board of Trustees to change eligibility or benefits subject to the terms and conditions of collective bargaining agreements and any applicable laws or regulations. The Plan may also be suspended or terminated at any time by the Trustees.
